The health impacts of climate change are already being felt by vulnerable communities, particularly in the Global South. It is widely purported that women in the Global South will be more adversely affected by climate change than men, yet there remains a dearth of empirical evidence to confirm or challenge this idea. Somewhat similarly, in human performance and occupational health literature, women were assumed to be more susceptible to the ill effects of excessive heat exposure (i.e., exertional heat stroke) based on limited empirical evidence that is now being challenged. Using a multi-year cohort study on industrial agricultural workers in Central America (the Adelante Initiative) as a case study, this session will discuss how sex-related physiological differences and lessons learnt from exercise physiology research can inform occupational health outcomes in male and female working populations in the Global South. 
Case study: The Adelante Initiative began in 2017 in response to the Central American epidemic of chronic kidney disease of non-traditional origin, which is highly prevalent in agricultural workers in this region. The primary aim of this Initiative was to assess how a rest, shade, hydration intervention programme impacted the heath and work conditions of sugarcane workers at one of the largest sugarcane mills in Central America (Ingenio San Antonio). Heat stress, kidney health outcomes and workload in workers performing manual outdoor jobs (e.g., burned cane cutting, seed cutting, drip irrigation repair) were assessed longitudinally (2017-present). Very few females are currently employed as burned cane cutters at ISA. However, females are increasingly being employed in other strenuous outdoor work (i.e., seed cutting) and consequently are exposed to occupational heat stress and its associated health risks. Initial data indicates that females work at a higher physiological workload than their male counterparts. Due to a limited sample size, it is unclear if females in this work context suffer a higher incidence of kidney injury or other heat-related illness than men. 
The introduction of women into a susceptible workforce such as industrial sugarcane workers, provides a unique opportunity to assess biological sex-differences in heat-related illnesses/injuries and thus gain further insight into the aetiology of diseases such as chronic kidney disease of non-traditional origin. In workforces exposed to occupational heat stress, population-level physical differences and biological differences between men and women should be factored into exposure assessments and workplace interventions. Male:female workforce ratios, particularly in jobs historically dominated by one gender, provides further information on who is at risk, what personal factors are most relevant and therefore, what interventions are the most practically beneficial. To address gender health inequalities in climate change and occupational health research it is imperative that we make every effort to include women in ongoing and future research.